scholarly journals The health and economic burden of the coronavirus in sub-Saharan Africa

2020 ◽  
pp. 175797592097787
Author(s):  
Byron K. Y. Bitanihirwe ◽  
Derrick Ssewanyana
Keyword(s):  
Low Income ◽  
Scale Up ◽  
Safety Net ◽  
Negative Influence ◽  
Lessons Learned ◽  
Control Measures ◽  
Sub Saharan Africa ◽  
Infection Prevention And Control ◽  
Sub Saharan ◽  
The Impact

The current coronavirus (COVID-19) pandemic continues to overwhelm healthcare systems and to exert a negative influence on the global economy. Of particular concern is the impact of COVID-19 in low-income settings—especially in terms of their capacity to mitigate a surge in COVID-19 cases. Indeed, response measures currently in place to tackle the spread of COVID-19 in geographic regions predominantly consisting of low-income nations, such as Sub-Saharan Africa (SSA), remain tenuous and will require context-appropriate interventions. Control measures to tackle COVID-19 in SSA should therefore be informed through lessons learned from past outbreaks and emergencies on the continent. These lessons will represent a key source of guidance for the strategic implementation and promotion of public health interventions to assist scale-up of COVID-19 case management, infection prevention and control. Importantly, as governments in SSA continue to combat the spread of COVID-19, there will be a need to expand the coverage of social safety net programs and fiscal policy responses to tackle the socio-economic and health impact of COVID-19.

scholarly journals The impact of African-trained neurosurgeons on sub-Saharan Africa

2020 ◽  
Vol 48 (3) ◽  
pp. E4 ◽  
Author(s):  
Claire Karekezi ◽  
Abdeslam El Khamlichi ◽  
Abdessamad El Ouahabi ◽  
Najia El Abbadi ◽  
Semevo Alidegnon Ahokpossi ◽  
...  
Keyword(s):  
Low Income ◽  
National Income ◽  
Sub Saharan Africa ◽  
World Federation ◽  
Neurosurgical Procedures ◽  
Ct Scanner ◽  
The Past ◽  
The World ◽  
Sub Saharan ◽  
The Impact

OBJECTIVESub-Saharan Africa (SSA) represents 17% of the world’s land, 14% of the population, and 1% of the gross domestic product. Previous reports have indicated that 81/500 African neurosurgeons (16.2%) worked in SSA—i.e., 1 neurosurgeon per 6 million inhabitants. Over the past decades, efforts have been made to improve neurosurgery availability in SSA. In this study, the authors provide an update by means of the polling of neurosurgeons who trained in North Africa and went back to practice in SSA.METHODSNeurosurgeons who had full training at the World Federation of Neurosurgical Societies (WFNS) Rabat Training Center (RTC) over the past 16 years were polled with an 18-question survey focused on demographics, practice/case types, and operating room equipment availability.RESULTSData collected from all 21 (100%) WFNS RTC graduates showed that all neurosurgeons returned to work to SSA in 12 different countries, 90% working in low-income and 10% in lower-middle-income countries, defined by the World Bank as a Gross National Income per capita of ≤ US$995 and US$996–$3895, respectively. The cumulative population in the geographical areas in which they practice is 267 million, with a total of 102 neurosurgeons reported, resulting in 1 neurosurgeon per 2.62 million inhabitants. Upon return to SSA, WFNS RTC graduates were employed in public/private hospitals (62%), military hospitals (14.3%), academic centers (14.3%), and private practice (9.5%). The majority reported an even split between spine and cranial and between trauma and elective; 71% performed between 50 and more than 100 neurosurgical procedures/year. Equipment available varied across the cohort. A CT scanner was available to 86%, MRI to 38%, surgical microscope to 33%, endoscope to 19.1%, and neuronavigation to 0%. Three (14.3%) neurosurgeons had access to none of the above.CONCLUSIONSNeurosurgery availability in SSA has significantly improved over the past decade thanks to the dedication of senior African neurosurgeons, organizations, and volunteers who believed in forming the new neurosurgery generation in the same continent where they practice. Challenges include limited resources and the need to continue expanding efforts in local neurosurgery training and continuing medical education. Focus on affordable and low-maintenance technology is needed.

A Systems Approach for Sustainably Reducing Childhood Diarrheal Deaths in Developing Countries

2016 ◽  
pp. 1208-1227
Author(s):  
Monica Gray
Keyword(s):  
Developing Countries ◽  
Low Income ◽  
Systems Approach ◽  
Developed Countries ◽  
Lessons Learned ◽  
Sub Saharan Africa ◽  
Low Income Countries ◽  
Health Crisis ◽  
Industrialized Nations ◽  
Sub Saharan

Diarrhea is the second leading cause of death and is the major cause of malnutrition in children under age 5 worldwide. More than 50 percent of the cases occur in developing countries, particularly in sub-Saharan Africa and Southeast Asia. Open defecation, substandard fecal disposal systems, and contaminated water supplies are the typical causes of diarrheal diseases. This public health crisis in low income countries mirrors the experiences of today's industrialized nations two centuries ago. The lessons learned from their sanitary evolution can be instructive in charting a sustainable path towards saving the lives of almost 2 million children annually. In this chapter a case study of Cuba's sanitary reformation is also presented to showcase successes, similar to those of developed countries, within a developing country and economically challenging context.

scholarly journals Characterizing the contribution of high temperatures to child undernourishment in Sub-Saharan Africa

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Rachel E. Baker ◽  
Jesse Anttila-Hughes
Keyword(s):  
High Temperatures ◽  
Low Income ◽  
Child Nutrition ◽  
Negative Relationship ◽  
Sub Saharan Africa ◽  
Eastern Africa ◽  
Multiple Time Scales ◽  
Multiple Time ◽  
Sub Saharan ◽  
The Impact

Abstract Despite improvements to global economic conditions, child undernourishment has increased in recent years, with approximately 7.5% of children suffering from wasting. Climate change is expected to worsen food insecurity and increase potential threats to nutrition, particularly in low-income and lower-middle income countries where the majority of undernourished children live. We combine anthropometric data for 192,000 children from 30 countries in Sub-Saharan Africa with historical climate data to directly estimate the effect of temperature on key malnutrition outcomes. We first document a strong negative relationship between child weight and average temperature across regions. We then exploit variation in weather conditions to statistically identify the effects of increased temperatures over multiple time scales on child nutrition. Increased temperatures in the month of survey, year leading up to survey and child lifetime lead to meaningful declines in acute measures of child nutrition. We find that the lifetime-scale effects explain most of the region-level negative relationship between weight and temperature, indicating that high temperatures may be a constraint on child nutrition. We use CMIP5 local temperature projections to project the impact of future warming, and find substantial increases in malnutrition depending on location: western Africa would see a 37% increase in the prevalence of wasting by 2100, and central and eastern Africa 25%.

Grey relational evaluation of impact and control of malaria in Sub-Saharan Africa

2019 ◽  
Vol 9 (4) ◽  
pp. 415-431 ◽  
Author(s):  
Tawiah Kwatekwei Quartey-Papafio ◽  
Sifeng Liu ◽  
Sara Javed
Keyword(s):  
West Africa ◽  
Malaria Incidence ◽  
Control Measures ◽  
Sub Saharan Africa ◽  
Content Type ◽  
Independent States ◽  
Sub Saharan ◽  
And Control ◽  
Grey Relational ◽  
The Impact

Purpose The rise in malaria deaths discloses a decline of global malaria eradication that shows that control measures and fund distribution have missed its right of way. Therefore, the purpose of this paper is to study and evaluate the impact and control of malaria on the independent states of the Sub-Saharan African (SSA) region over the time period of 2010–2017 using Deng’s Grey incidence analysis, absolute degree GIA and second synthetic degree GIA model. Design/methodology/approach The purposive data sampling is a secondary data from World Developmental Indicators indicating the incidence of new malaria cases (per 1,000 population at risk) for 45 independent states in SSA. GIA models were applied on array sequences into a single relational grade for ranking to be obtained and analyzed to evaluate trend over a predicted period. Findings Grey relational analysis classifies West Africa as the highly infectious region of malaria incidence having Burkina Faso, Sierra Leone, Ghana, Benin, Liberia and Gambia suffering severely. Also, results indicate Southern Africa to be the least of all affected in the African belt that includes Eswatini, Namibia, Botswana, South Africa and Mozambique. But, predictions revealed that the infection rate is expected to fall in West Africa, whereas the least vulnerable countries will experience a rise in malaria incidence through to the next ten years. Therefore, this study draws the attention of all stakeholders and interest groups to adopt effective policies to fight malaria. Originality/value The study is a pioneer to unravel the most vulnerable countries in the SSA region as far as the incidence of new malaria cases is a concern through the use of second synthetic GIA model. The outcome of the study is substantial to direct research funds to control and eliminate malaria.

scholarly journals Lessons from a decade of voluntary medical male circumcision implementation and their application to HIV pre-exposure prophylaxis scale up

2018 ◽  
Vol 29 (14) ◽  
pp. 1432-1443 ◽  
Author(s):  
Jason B Reed ◽  
Rupa R Patel ◽  
Rachel Baggaley
Keyword(s):  
Male Circumcision ◽  
Scale Up ◽  
Health Impact ◽  
Lessons Learned ◽  
Sub Saharan Africa ◽  
Voluntary Medical Male Circumcision ◽  
Medical Male Circumcision ◽  
Prep Implementation ◽  
Sub Saharan ◽  
Exposure Prophylaxis

Oral pre-exposure prophylaxis (PrEP) has the ability to curb HIV incidence worldwide and bring us closer to ending the HIV epidemic. Scale up of PrEP service delivery has many similar challenges to those faced by voluntary medical male circumcision (VMMC) services roll-out. This article outlines ten important lessons learned during the scale up of VMMC services in sub-Saharan Africa and their application to current oral PrEP implementation efforts to promote faster expansion for public health impact.

scholarly journals Rural prioritization may increase the impact of COVID-19 vaccines in Sub-Saharan Africa due to ongoing internal migration: A modeling study

2021 ◽  
Author(s):  
Prashanth Selvaraj ◽  
Bradley G Wagner ◽  
Dennis L Chao ◽  
Maina L'Azou Jackson ◽  
J. Gabrielle Breugelmans ◽  
...  
Keyword(s):  
Internal Migration ◽  
Disease Transmission ◽  
Vaccination Campaign ◽  
Scale Up ◽  
Sub Saharan Africa ◽  
Age Group ◽  
Migration Rates ◽  
Urban Rural ◽  
Sub Saharan ◽  
The Impact

How COVID-19 vaccine is distributed within low- and middle-income countries has received little attention outside of equity or logistical concerns but may ultimately affect campaign impact in terms of infections, severe cases, or deaths averted. In this study we examined whether subnational (urban-rural) prioritization may affect the cumulative two-year impact on disease transmission and burden of a vaccination campaign using an agent-based model of COVID-19 in a representative Sub-Saharan Africa country setting. We simulated a range of vaccination strategies that differed by urban-rural prioritization, age group prioritization, timing of introduction, and final coverage level. Urban prioritization averted more infections in only a narrow set of scenarios, when internal migration rates were low and vaccination was started by day 30 of an outbreak. Rural prioritization was the optimal strategy for all other scenarios, e.g., with higher internal migration rates or later start dates, due to the presence of a large immunological naive rural population. Among other factors, timing of the vaccination campaign was important to determining maximum impact, and delays as short as 30 days prevented larger campaigns from having the same impact as smaller campaigns that began earlier. The optimal age group for prioritization depended on choice of metric, as prioritizing older adults consistently averted more deaths across all of the scenarios. While guidelines exist for these latter factors, urban-rural allocation is an orthogonal factor that we predict to affect impact and warrants consideration as countries plan the scale-up of their vaccination campaigns.

scholarly journals The introduction of genetic counseling in Ethiopia: Results of a training workshop and lessons learned

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0255278
Author(s):  
Shane C. Quinonez ◽  
Bridget C. O’Connor ◽  
Michelle F. Jacobs ◽  
Atnafu Mekonnen Tekleab ◽  
Ayalew Marye ◽  
...  
Keyword(s):  
Genetic Counseling ◽  
Congenital Anomalies ◽  
Addis Ababa ◽  
Curriculum Evaluation ◽  
Medical Knowledge ◽  
Lessons Learned ◽  
Sub Saharan Africa ◽  
Assessment Scores ◽  
Sub Saharan ◽  
The Impact

Background Over the past two decades non-communicable diseases (NCDs) have steadily increased as a cause of worldwide disability and mortality with a concomitant decrease in disease burden from communicable, maternal, neonatal and nutritional conditions. Congenital anomalies, the most common NCD affecting children, have recently become the fifth leading cause of under-five mortality worldwide, ahead of other conditions such as malaria, neonatal sepsis and malnutrition. Genetic counseling has been shown to be an effective method to decrease the impact of congenital anomalies and genetic conditions but is absent in almost all sub-Saharan Africa countries. To address this need for counseling services we designed and implemented the first broad-based genetic counseling curriculum in Ethiopia, launching it at St. Paul’s Millennium Medical College (SPHMMC) in Addis Ababa, Ethiopia. Methods The curriculum, created by Michigan Medicine and SPHMMC specialists, consisted of medical knowledge and genetic counseling content and was delivered to two cohorts of nurses. Curriculum evaluation consisted of satisfaction surveys and pre- and post-assessments covering medical knowledge and genetic counseling content. Following Cohort 1 training, the curriculum was modified to increase the medical knowledge material and decrease Western genetic counseling principles material. Results Both cohorts reported high levels of satisfaction but felt the workshop was too short. No significant improvements in assessment scores were seen for Cohort 1 in terms of total scores and medical knowledge and genetic counseling-specific questions. Following curriculum modification, improvements were seen in Cohort 2 with an increase in total assessment scores from 63% to 73% (p = 0.043), with medical knowledge-specific questions increasing from 57% to 79% (p = 0.01) with no significant change in genetic counseling-specific scores. Multiple logistic, financial, cultural and systems-specific barriers were identified with recommendations for their consideration presented. Conclusion Genetics medical knowledge of Ethiopian nurses increased significantly following curriculum delivery though difficulty was encountered with Western genetic counseling material.

scholarly journals Government Expenditure and Economic Growth in Sub-Saharan Africa

2021 ◽  
Vol 7 (4) ◽  
pp. p14
Author(s):  
Dickson Wandeda ◽  
Wafula Masai ◽  
Samuel M. Nyandemo
Keyword(s):  
Economic Growth ◽  
Panel Data ◽  
Low Income ◽  
Government Expenditure ◽  
Output Growth ◽  
Sub Saharan Africa ◽  
Middle Income ◽  
Sub Saharan ◽  
The Impact ◽  
Ssa Countries

The paper sought to investigate the effect government expenditure on economic growth in Sub-Saharan Africa using a panel data for 35 Sub-Saharan African countries for the period 2006-2018. The paper adopted dynamic panel data and estimates were achieved by using two-step system GMM while taking into account the problem of instrument proliferation. The paper provided evidence that education and health expenditure are key determinants of income growth for SSA. The impact of education spending on cross-country income variation is more effective in low income SSA countries than the middle income SSA countries. However, military expenditure on output growth is more effective in improving income level of middle income SSA countries than low income SSA countries. SSA countries should allocate more funding towards education sector and should also avail compulsory and free primary and secondary education. SSA should carry out health reforms which improve primary health and universal health insurance coverage.

scholarly journals The impact of COVID-19 control measures on social contacts and transmission in Kenyan informal settlements

2020 ◽  
Author(s):  
Matthew Quaife ◽  
Kevin van Zandvoort ◽  
Amy Gimma ◽  
Kashvi Shah ◽  
Nicky McCreesh ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Food Security ◽  
Informal Settlements ◽  
Control Measures ◽  
Sub Saharan Africa ◽  
Social Contacts ◽  
Contact Patterns ◽  
Contact Data ◽  
Sub Saharan ◽  
The Impact

AbstractBackgroundMany low- and middle-income countries have implemented control measures against coronavirus disease 2019 (COVID-19). However, it is not clear to what extent these measures explain the low numbers of recorded COVID-19 cases and deaths in Africa. One of the main aims of control measures is to reduce respiratory pathogen transmission through direct contact with others. In this study we collect contact data from residents of informal settlements around Nairobi, Kenya to assess if control measures have changed contact patterns, and estimate the impact of changes on the basic reproduction number (R0).MethodsWe conducted a social contact survey with 213 residents of five informal settlements around Nairobi in early May 2020, four weeks after the Kenyan government introduced enhanced physical distancing measures and a curfew between 7pm and 5am. Respondents were asked to report all direct physical and non-physical contacts made the previous day, alongside a questionnaire asking about the social and economic impact of COVID-19 and control measures. We examined contact patterns by demographic factors, including socioeconomic status. We described the impact of COVID-19 and control measures on income and food security. We compared contact patterns during control measures to patterns from non-pandemic periods to estimate the change in R0.FindingsWe estimate that control measures reduced physical and non-physical contacts, reducing the R0 from around 2.6 to between 0.5 and 0.7, depending on the pre-COVID-19 comparison matrix used. Masks were worn by at least one person in 92% of contacts. Respondents in the poorest socioeconomic quintile reported 1.5 times more contacts than those in the richest. 86% of respondents reported a total or partial loss of income due to COVID-19, and 74% reported eating less or skipping meals due to having too little money for food.InterpretationCOVID-19 control measures have had a large impact on direct contacts and therefore transmission, but have also caused considerable economic and food insecurity. Reductions in R0 are consistent with the linear epidemic growth in Kenya and other sub-Saharan African countries that implemented similar, early control measures. However, negative and inequitable impacts on economic and food security may mean control measures are not sustainable in the longer term.Research in contextEvidence before this studyWe conducted a PubMed search on 6 June 2020 with no language restrictions for studies published since inception, using the search terms (“social mix*” OR “social cont*” OR “contact pattern*) AND (“covid*”). The search yielded 53 articles, two of which reported changes in social contacts after COVID-19 control measures. The first study reported changes in contact patterns in Wuhan and Shanghai, and the second changes in contact patterns in the UK. We found no studies examining changes in contact patterns due to control measures in sub-Saharan Africa, and no studies disaggregating contacts by socioeconomic status.Added value of this studyThis is the first study to estimate the reproduction number of COVID-19 under control measures in sub-Saharan Africa using primary contact data. This study also moves beyond existing work to i) measure contacts in densely populated informal settlements, ii) explore how social contacts vary across socioeconomic status, and iii) assess the impact of control measures on economic and food security in these areas.Implications of all the evidenceCOVID-19 control measures have substantially reduced social contacts and disease transmission. People of lower socioeconomic status face greater transmission risk as they report more contacts. Control measures have led to considerable economic and food insecurity, and may not be sustainable in the long term without efforts to reduce the burden of control measures on households.

Sign in / Sign up

Export Citation Format

Share Document